Structural Approaches in Public Health
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The human rights commission can investigate the claims and assess if the State has breached the Human Rights Standards. IAPO can act on behalf of its members on local issues. We now have a golden opportunity to achieve patient-centred health systems by using human rights-based approaches to health. We have formed a partnership with Advocates for International Development to take this further,.
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How does it work? Globalization can be viewed as a multidimensional process that includes economic, political, cultural, social, and technical-scientific aspects and fosters migration flows by which knowledge and technologies permeate national borders, favoring the development of new common goods 5. In this globalized world, the structural approach to cooperation represents a significant shift of focus away from the traditional model of technical cooperation promoted by developed countries.
In this model, cooperation initiatives are generally guided by previously defined objectives and, more often than not, based on donor concerns about the risk of health problems spreading to their own populations. As mentioned above, this approach targets specific diseases, which, at the present time, does not seem to be sufficient and fails to leverage the full potential of this type of assistance.
This observation echoes some of the reflections from international meetings hosted by the Organization for Economic Co-operation and Development OECD in the first decade of this century aimed at improving the effectiveness of development cooperation, notably that which took place in Paris in This meeting underlined the need to promote joint planning with partner countries, harmonization of activities, partner country ownership, and mutual accountability 6.
This approach has also begun to be applied to North-South cooperation, whereby negotiations between donors and partner countries have become less prescriptive.
However, the approach is particularly effective when applied to exchanges between developing countries, affording elements that build upon our structural cooperation proposal through relationships that go beyond the aid criterion and can be characterized as actions between partner countries. Unlike the more traditional disease-specific approach, strengthening and transforming health systems as a whole creates the necessary conditions for more general actions that have the potential to combat a variety of illnesses.
In addition, as mentioned above, this approach focuses on health promotion, considering not only the biomedical aspects of disease, but also the social and environmental determinants of health. With a view to enhancing the effectiveness of structural cooperation in situations where actions of the same type strengthening or supporting national health institutions, schools of public health, and other bodies are undertaken in different countries, partner countries seek to establish institutional relations to enable sharing of experiences and human resources through structuring networks, thus maximizing outcomes for each country.
In general, structuring institutions carry much political weight within their respective countries, which often seek to pursue common agendas oriented by regional political and cooperation arrangements, such as the Union of South American Nations UNASUL, acronym in Portuguese and Community of Portuguese-speaking Countries CPLP, acronym in Portuguese , which discuss issues related to international cooperation for health between member countries 7.
The Oswaldo Cruz Foundation has a complex structure, which has enabled the organization of the structuring networks mentioned above, thus supporting health system strengthening in the countries in these regions.
Structural Interventions to Reduce and Eliminate Health Disparities | AJPH | Vol. Issue S1
The international community has shown strong commitment to overcoming global imbalances, an example of which is Agenda and its Sustainable Development Goals SDGs , adopted by heads of state at the General Assembly of the United Nations in The last goal number 17 proposes to revitalize partnerships for capacity building to support national plans to implement these goals. In this respect, emphasizing long-term needs, we sought solutions that leverage the maximum potential of international cooperation for health between developing countries by strengthening key institutions that have the potential to promote true leadership in the sector.
The structural cooperation approach fulfills this objective by promoting actions that address the social determinants of health rather than just individual medical care 1 , taking into account the synergies between the SDGs. It is known that the power asymmetries between developing and developed countries, especially within the economic and technical-scientific dimensions, interfere in the cooperation process 2.
As such, structural cooperation for health broadens the scope of international cooperation between developing countries towards research, technological development and innovation in this field of knowledge within the social dimension, paving a path towards equality in these countries. As such, this approach shows its sophistication and superiority over other approaches that offer less scope, contributing towards ensuring sustainable intended outcomes within the deadline set by the United Nations.
Rio de Janeiro: Editora Fiocruz; No Prelo. Neto WAD. OIKOS ; 13 2 Regenerar a democracia.
Le Monde Diplomatique Ano 9 , abril. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Services on Demand Journal. Abstract This article examines the structural approach to health cooperation, focusing on its meaning as a method for promoting institutional policies to improve management models. Introduction and concept Words are alive: they are born, mature and die.
Operational overview The main focus of structural cooperation for health is training and capacity building for health systems strengthening.